Trying to decide

[Sunnyer 131]

I have thought about weight loss surgery for a few years and seriously for a year now. I've been overweight for over 20 years, and in the last nine years I have gained around 44 pounds. Currently I'm around 80 pounds overweight with a BMI of 37.

Like so many here, I've tried so many things to lose weight. Meal Replacement shakes, weight loss club, exercise, different kinds of low carb eating etc., with diminishing results. The last time I lost any significant amount of weight was almost decade ago, when I was pregnant with my son. I lost about 22 pounds from before I was pregnant, but I gained it back double in the years that followed. I was at my highest weight in 2019, and since then I've managed to lose and gain the same 10-15 pounds several times.

Before I was a mom, I used to exercise regularly, but as a new single mom with a full time job, I didn't have the time. I started with a low carb diet four years ago and started exercising in a gym a year after that, but then covid came and all the gyms closed. I started having blood pressure problems at the end of 2019, and it has gotten worse since. I'm now on two different medication for blood pressure, plus Metaformin for blood sugar. I got covid last winter and after that my stamina is a lot worse, so I feel like I'm fighting an uphill battle I keep losing.

I have the money to pay for surgery, if I go overseas to have it. I'm in northern Europe and am considering two private hospital in Eastern European countries. I guess I'm afraid of complications, of dying and of not getting the desired results. A part of me feels I should just be able to exercise and do Keto to lose the weight, but I've tried it so many times and failed. As I said, I'm a single mom and want to live a long and healthy life for my son, who does not have another active parent in his life. I've only told one friend that I'm considering this surgery, but I hesitate to tell my family. I'm the only overweight person in my family and I'm not sure they'll be supportive.

Did anyone else struggle this much with deciding to have surgery or not, and what finally helped you to decide?

[catwoman7 11,212]

major complications and dying from surgery are VERY rare. That was more of an issue 30 or 40 years ago, but techniques have improved tremendously since then.

but yes - I had the same worries and went back & forth about having surgery for about 10 years before I did it. I think what decided it for me was the realization that I was more likely to die from complications of being obese than I was from complications from the surgery.

[summerseeker 2,139]

We all come to the end of the line at some point. That's it no more. I just knew. My personal preference would be to have the surgery as local as possible because you might need extra help, I did.

[Sunnyer 131]

3 hours ago, catwoman7 said:

major complications and dying from surgery are VERY rare. That was more of an issue 30 or 40 years ago, but techniques have improved tremendously since then.

but yes - I had the same worries and went back & forth about having surgery for about 10 years before I did it. I think what decided it for me was the realization that I was more likely to die from complications of being obese than I was from complications from the surgery.

I've seen statistics from the US that show that death from gastric sleeve is very rare. However, I live in a small country and there are only two places that do weight loss surgeries locally.

One is a state run hospital, that has a very good track record and nobody has died from weight loss surgery there, but it's very hard to get surgery there. In order to qualify for surgery there, you first have to go to an inpatient program at a state run rehabilitation centre and the waiting list for that is measured in years, not months.

There used to be two private clinics who did weight loss surgeries locally, but after two people died from gastric sleeve in 2018 and one case of serious complications, on of them closed. In all, six people had died after a gastric sleeves performed by their surgeon. They had limited aftercare and the same applies to the private clinic that is still working. Also, I wouldn't be able to go this summer if I chose the private clinic locally, since it costs more and they have a long waiting list too.

We have socialised medicine, so if you have complications afterwards you are referred to the state hospital or public health clinics. In Poland, I would stay for at least two days after surgery at the hospital and up to five days, and they have an excellent track record. You can choose a trip that last for five days or seven days, and I would chose the longer one. It's similar in the other country I'm considering, which is Latvia.

Does it still seem unreasonable to go overseas for the surgery in my circumstances?

[Sleeve_Me_Alone 656]

I am in the US, but I chose to travel to Mexico for my surgery. Medical Tourism all over the world is VERY common and if you do your research and choose a reputable facility with fully qualified surgeons, your outcome will likely be identical to having the procedure done in your home country. There are good and bad surgeons anywhere, so ultimately, WHERE you do it is far less relevant than WHO you do it with. It sounds like you are well informed and have made a decision based on the sum of your knowledge.

[Spinoza 1,377]

I thought about bariatric surgery for over 10 years. The decision to go for it in the end wasn't precipitated by one event, more an accumulation of little embarrassments like the seatbelt on an airplane only just buckling, my hairdresser having to bring out a special chair for me in case I broke the new fancy ones with the spindly legs, reaching a BMI of 40. Even after those it took me months to decide who to go with - I definitely looked at Eastern Europe because it's so much cheaper there but my partner was so worried about me having surgery abroad that in the end I just paid up and did it here. I spent my entire adult life believing that I should be able to lose weight on my own (I could) and keep it off (no chance). I really wish I had just gone for it 10+ years ago when I first considered it.

I think you're absolutely right to do ALL the thinking before going ahead and I wish you the very very best of luck wherever you have your surgery.

Edited June 6, 2022 by Spinoza
typo

[daynuhlicious 61]

I have been on the fence for a while as well. In fact I flat out refused to do it for the longest time, wanting to lose the weight myself. The odds were stacked against me, however, as they are for most people. I started going to the gym with my fiance, and we were keeping a routine. I was well on my way. Then Covid struck. Who knows where I'd be at weight wise by now if I had been able to continue my gym experience. Now I'm just scared to go back because I don't know who has Covid and who adequately monitors themselves. So many people are like eh whatever, you don't know what you're getting into just going to the grocery store!

However ... I'm sure it will be a heart attack that kills me before the surgery will. I have 2 bonus kids that need me in their life. I want to be there for them. I've not been able to ensure that on any level for years. It's time. I want to not hurt when I stand or walk. It's just time. Quite plainly.

It also helps that I had my gallbladder removed. That was my first ever surgery and it helped me with my trust in the process when it comes to intricate dealings like surgeries. It also increased my confidence that I was required to find a Blue Ribbon facility by my insurance - further decreasing the likelihood of negative outcomes or side effects. Another thing that boosted my confidence is when I found out my surgeon has done over 2000 procedures and not one has had a leak following it. I know I'm in good hands.

I have an aunt and both her daughters that had the surgery as well. My fiance is very supportive. A strong support system is probably THE most important thing you can have. That being said, to hell with anyone, family or otherwise, who is not supportive of you and your decisions to create a better you. Find a new group to surround yourself with. Surgery and the lifetime following it are NOT the easy ways out. It is a complete 180 lifestyle change for most and it's hard. But it's worth it and it will keep you here longer for your child. THAT is what matters.

Best wishes for you in your future, whatever you decide.

[Sunnyer 131]

I did tell another friend today, and she was a bit negative. She mentioned that someone she worked with had gone under the knife at the local private clinic that's still operating, and that she had complications and had to have surgery two more times. She didn't know if this person had a gastric bypass or sleeve, but it was a few years ago.

She also mentioned another friend of hers who had weight loss surgery in Poland, everything went well but my friend said that this person had never looked worse in her life and that the surgery had aged her terribly. She mentioned wrinkles and Hair loss, and that her friend still had very thin hair although it's been two years since her surgery.

I have a neighbor who had a gastric sleeve in Eastern Europe a year ago. She does have more wrinkles than before, but her hair is just as thick as ever, so I guess it varies. This neighbor of mine had more wrinkles than average before surgery, since she was both a smoker (recently quit) and an avid sun worshipper.

I have almost no wrinkles although I'm middle aged. None on my forehead or in my face in general, except for little bags under the eyes and crinkly lines in the corners of my eyes. I've used prescription retinoids since I was in my twenties, and I'm sure that helped. How likely am I to become super wrinkly if I lose 40 - 80 pounds? I understand that on the average people lose 70% of their excess weight with the gastric sleeve, so for me that would be around 56 pounds.

I weighed 46 pounds less than I do now nine years ago, and I looked a lot better at that weight with no noticeable extra lines. Is it likely to be that much worse if the weight loss is through surgery? What is your experience, those of you who have already had the surgery?

Edited June 7, 2022 by Sunnyer

[Sunnyer 131]

Also, after this discussion with my friend, I came home, opened the website of a local newspaper, and at the top of the "most read" articles today, there was an interview with a woman who runs a food addiction clinic, the only one of its kind in the country.

The headline was that up to 60% of those who had gastric sleeve ended up with an alcohol addiction instead. She didn't give a citation for her claim, so I don't know how accurate that is or if it has any basis in reality at all. She said that alcohol goes into the blood stream faster when you have a smaller stomach and so people developed an alcohol problem, swapping food addiction for another addiction.

IDK, I drink alcohol maybe five or six times a year, and most often it's just a glass of wine at dinner. I googled this a bit and found a US study that said that around 20% of all people who underwent bariatric surgery in several centers in the US during a certain time period had developed problematic drinking. That correlation was strongest for people who had gastric bypass, where 20% of people had, according to the study, developed a full blown alcohol addiction. So, it looks like she exaggerated the risk.

The headline shocked me a bit, but diving into the studies risk factors included being male (not me), younger (nope), smoking (nope) and drinking regularly (I don't know if a few times a year can be called regular) and having less social support (less than what?). Have you heard of or considered this risk factor? One of the articles I read said you should avoid alcohol altogether for the first year after surgery, is that something you have done or heard of?

[Arabesque 7,240]

I’d look into surgery in a neighbouring country. There are a few Europeans on the forum who may be able to make some recommendations.

There are always negative stories & a friend of a friend stories. You can find them about anything. I recently read a story about the prevalence of fungal infections in people who to go to the large nail salons so … People who have good experiences don’t always shout it from the roof tops. We do here though. 🙂 Sure, there can be hiccups & things may not go perfectly to begin but generally everything settles & works out in the end or can be remedied rather easily. Some issues arise because of complications from pre existing conditions too. Talk to people who actually had the surgery (like on here) if you can.

You also get negativity from people who think the surgery is an easy way out. It is so NOT easy. They think if you just diet harder & be more committed to exercising you’ll lose weight. If it was as easy as just dieting & exercising you’d be thin now. We all would have been. The negative comments from family &/or friends are why some of us don’t tell people we’ve had the surgery.

The potential for developing a drinking addiction arises in response to people not being able to satisfy their food addiction anymore so they turn to alcohol (or sex apparently). I’ve seen stats of 16% after bypass in the first year of which 6% had existing issues with alcohol. Stating a 60% statistic would only benefit the woman in the article’s business by scaring people. If you deal with the issues behind your food addiction your chance for any addiction transfer is negated. It is important to do the ‘head work’ to understand, manage & deal with the issues behind your eating habits, behaviours, cravings, etc. Many people seek the support of a therapist after surgery which benefits their weight loss success & maintenance.

The Hair loss lasts about three months. Your natural hair loss cycle accelerates in response to the shock of the surgery & your change & reduced diet. So the hair you shed is hair you would be losing anyway - just not as quickly. Your new hair is still growing but just at its usual rate.

How many wrinkles you have is much like how much loose skin you will have. It will depend on your age, gender, skin elasticity, genetics, how long you carried your weight, etc. Yes, you likely will look more drawn & have a few additional wrinkles at first but a lot of this reduces in maintenance as your body resettles & you’re eating more & a more nutritious & balanced diet. My uncle told my mother I looked like death when I was near my lowest weight. Now, he tells me I look fabulous. I had a lot of fine lines that developed under my chin while I was losing but they almost totally disappeared in my second year. Sure my marionette lines are deeper & that’s from the skin that stretched from having a fat face. I have the face that is mine now. I have a jawline, a longer neck, cheek bones, & my eyes aren’t as hooded. A few wrinkles are nothing. I’d rather have a few wrinkles or loose skin than be obese & be compromising my health. Besides a little Botox or filler can always help with the wrinkles 😉.

Ultimately it is your decision. Keep asking questions so you’re as well informed as you can be. All the best whatever path you choose.

Edited June 7, 2022 by Arabesque

[mngoula 0]

I did mine in Hisar intercontinental hospital in Turkey. Everything went amazing. I recommend

Sent from my VOG-L29 using BariatricPal mobile app

[summerseeker 2,139]

To answer a few of your questions, no one answer fits everybody as @Arabesque say.

Will your hair fall out ?? who knows, Has mine? OMG yes but I can feel the new hair sprouting.

Will you wrinkle ?? who knows, Have I ? OMG yes but I was a very overweight soon to be 63 years old. Do I care ? nope because I wear pants and 3/4 sleeve tops that hide it all. My face is fine yet. I might have plastics in a few years if it bothers me then. I am saving just in case.

I only told my friend of 57 years, my husband and my son. I don't want judgement or other peoples opinion, its irrelevant.

I was a weekend drinker in my early years but I like to be fairly sober these days as it messes with my medication. I have had a few drinks since surgery, I am quite partial to a Bloody Mary. I can probably count the drinks I have had in 6 months on one hand. I get a buzz off one. Will I become alcoholic ? No thanks

Keep doing your research, keep asking questions because in the end you are the only one who knows if its for you

[Sunnyer 131]

15 hours ago, Arabesque said:

I’d look into surgery in a neighbouring country. There are a few Europeans on the forum who may be able to make some recommendations.

There are always negative stories & a friend of a friend stories. You can find them about anything. I recently read a story about the prevalence of fungal infections in people who to go to the large nail salons so … People who have good experiences don’t always shout it from the roof tops. We do here though. 🙂 Sure, there can be hiccups & things may not go perfectly to begin but generally everything settles & works out in the end or can be remedied rather easily. Some issues arise because of complications from pre existing conditions too. Talk to people who actually had the surgery (like on here) if you can.

You also get negativity from people who think the surgery is an easy way out. It is so NOT easy. They think if you just diet harder & be more committed to exercising you’ll lose weight. If it was as easy as just dieting & exercising you’d be thin now. We all would have been. The negative comments from family &/or friends are why some of us don’t tell people we’ve had the surgery.

"They think if you just diet harder & be more committed to exercising you’ll lose weight." I guess that's right, and what's more I kind of think that too, even though I know it's not necessarily true. It kind of feels like failure. Like I'm giving up and I should just try harder. Never mind that I've basically been on a diet since I was 15 or so. I was never overweight until I was thirty after an injury, when I couldn't exercise, so for the first 15 years I dieted without actually being overweight.

I did mention the possibility of bariatric surgery to my mom today, and she was pretty negative too.

An old classmate of from primary school mine shared the interview with the food addiction lady on social media, and wrote that "you couldn't cut the food addiction out of the addicted person, any more than you could cut alcoholitsm out of someone by cutting their liver in half."

She went on to say that she weighed her three meals per day and abstained from xugar, dairy products and refined carbs. She has done this for 13 years and has lost 100 pounds and kept them off. I briefly thought about contacting the food addiction clinic, or Noom, since one of my friends lost 50 pounds least year with Noom. ,

But then I remember that I did try OA once, which I didn't like that much, and also I didn't lose any weight in spite of adhering to their program. I also tried Noom last year, but I didn't use it. Writing everything down and weighing is so annoying. Still, I feel like I'm failing and thinking of using a crutch when I should be doing this on my own.

[Arabesque 7,240]

5 hours ago, Sunnyer said:

… you couldn't cut the food addiction out of the addicted person, any more than you could cut alcoholitsm out of someone by cutting their liver in half."

This is true. That’s why therapy & understanding why you eat is a vital component of this process for many people. In the US a psychological assessment is part of the insurance approval process. In Australia, your surgeon recommends pre &/or post surgery therapy sessions.

The surgery affords many benefits that dieting &/or exercising alone does. It resets your body set point (the weight your body naturally gravitates to), boosts your metabolism, removes part of the area that produces the hunger hormone (ghrelin) & can affect the glp1 hormone that regulates hunger & the metabolism of glucose. There are also of course physical changes that restricts how much food you can eat.

You will have to change how & what you eat. (Many change when they eat too.) The surgery affords you the time to establish new habits, discover new foods & to work out what way of eating works best for you. I’ve tried many diets & I’m pig headed enough to stick to them for months without wavering but I’d always eventually go back to how & what I usually ate. I’ve never been able to maintain my weight like I can now. I made a decision to cut out a lot of sugar (real, artificial, substitutes) out of my diet. I don’t eat highly processed foods, avoid a lot of carbs & never have fast food. This has been what works for me. It may not work for you or complement your lifestyle.

I didn’t record my food intake & still don’t. I do random checks of my calories & regularly check nutrients & ingredients. The only thing I watch carefully is my Protein. Some people find tracking very helpful but it isn’t for everyone all the time. Though you may be required to do it for a while to ensure you’re getting in the nutrients you need.

But you have to be ready to do this. As I said it’s not easy. It was harder than any other diet I’ve done.

[Sunnyer 131]

I did take all of the advice I've gotten here into consideration, so thank you all for that. One thing I did do yesterday was to reach out to an acquaintance who had gastric sleeve three years ago in a neighboring country. Apparently, she did go through a local doctor who sent her to have surgery overseas but closer than Poland or other countries in Eastern Europe. And it was all paid by the national health insurance.

This doctor is an obesity expert and runs one of the two programs in the country that's recognized as adequate preparation for weight loss surgery, if you want to try to get the national insurance to pay for your operation. It's not on an inpatient basis, which is a plus. When my acquaintance did it, the wait between the prep course and the surgery was only three months, but it may be longer now.

I did email the doctor to ask for an appointment, but I have no idea if they're accepting new patients or if they have a long waiting list. If they're like other doctors, they'll be going on vacation soon and I may not get an appointment until the fall or later. And I may not qualify for surgery paid by the national health insurance, since their general rule is that they operate on people with BMI 40 or higher, and mine is 37.

As I understand it, they may approve surgery for someone with a BMI under 40 if they have enough co-morbidities. I have high blood pressure and the slightly elevated blood sugar test. I don't know if that's enough, but I guess I'll find out. If I don't qualify I probably won't be able to go to the hospital in the neighboring country that my acquaintance went to, since It's not a private hospital. At least, that's what she thought.

Edited June 9, 2022 by Sunnyer
correction